A Bayer of a Case

​A 30-year-old woman was brought in by EMS tearful and reluctant to answer questions initially. Her mother was with her and stated that the patient had been depressed and may have taken some pills in a suicide attempt. Her initial vitals on presentation were a temperature of 99.1°F, heart rate of 128 bpm, blood pressure of132/92 mm Hg, and a respiratory rate of 26 bpm. She had clear lungs and sinus tachycardia on cardiac monitoring. She admitted to having taken "a lot" of aspirin.Initial LabsCBC: WBC of 14, hemoglobin of 14 g/dL, hematocrit of 42%, platelet count of 250,000BMP: Sodium of 132 mEq/L, potassium of 4 mEq/L, Cl of 99 mEq/L, bicarbonate of 16 mEq/L, BUN of 30 mg/dL, creatinine of 1.2 mg/dL, glucose of 105 mg/dLLactate: 2.6 mmol/LSalicylate level: 62.2 mg/dLCommon Presentation of Salicylate ToxicityNausea, vomiting, gastric irritationTinnitus or hearing lossAltered mental status: confusion, agitation, somnolence, comaSeizuresHypoglycemiaTachypneaTachycardiaAcid-base disturbances: Central stimulation of the respiratory center results in hyperventilation, which leads to a respiratory alkalosis and a compensatory metabolic acidosis.Hyperthermia because of the effects intracellularly of uncoupling oxidative phosphorylationCerebral and pulmonary edemaAcute v. Chronic Salicylate IngestionAcute ingestion:Levels correlate with symptoms:30-45 mg/dL: Tinnitus and tachypnea45-60 mg/dL: Nausea and vomiting70-90 mg/dL: Tac...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs